July 22, 2014

On using the NHS

Until my heart attack I’d not been a heavy user of the NHS (UK healthcare system) apart from a few visits to my GP. So it was quite an eye-opener to find myself needing paramedics, ambulances, A&E and hospital treatment. So what was it like?

1. Overall I’m really impressed with the standard of care and the way I was treated. Apart from one Doctor, whose bedside manner could do with some work, everyone was helpful, friendly, positive and caring.

2. The system has a welcome bias to clinical need; even though this sometimes gets people worked up. I was grateful that when I first arrived in hospital people dealt with me first, even though the relative of the patient just up from me complained that she was still waiting, despite the Doctor apologising for the delay because another patient had arrived. (message to grumpy relative, you might be grateful one day that they think heart attack patients come first). Again, the following day, when I had to wait longer for my angiogram because of an emergency air ambulance admission, it felt OK because one day I too might need to jump the queue.

3. Hospitals are not sound proof. You regularly get to hear people talking about you, even though you might only pick up half of what’s said. On several occasions, I learned more about my condition from those conversations than I did from what was said to me. When I went to a ward I could hear the conversations from the nurses station as well, and learned all sorts of things.

4. Hospitals are noisy places, even at night there is lots of conversation, movement, taking observations and so on. Nights in hospital are similar to night flights on an aircraft, you are sort of comfortable and it is darker than day time, but the noise and disturbance prevents decent sleep.

5. The food is unlikely to win any awards and the coffee is awful. But, by the time you have the energy to complain they are trying to discharge you home. Tip: drink tea when the drinks trolley comes round and coffee when someone on the ward makes it for you.

6. The staff work hard. There seemed very few occasions when people where not busy (generally these were night staff) and several where folk seemed fully stretched. Some of the workload is the result of hospital systems. On the Saturday there was a fascinating series of telephone conversations between the ward and the ‘bed manager’ that got very heated and took up quite a lot of time; but it proved a waste of time when the next ward refused to take the patient from our ward and so there wasn’t a free bed to fill.

7. There are some things I would have liked to be different. It was only towards the end of my time I had the presence of mind to formulate specific questions, but all through my hospital experience I would have appreciated more detailed information and explanation. Perhaps because my last 48 hours in hospital were over the weekend, I missed any real opportunity to discuss my situation with Doctors with the result that I have learned more from messaging medical friends and researching on google since discharge than I did from those who had my notes and test results. Likewise, I would have appreciated more interest in my mental health and wellbeing rather than seeing it as something irrelevant to the immediate issue or something to be medicated away.

Health care is a political issue in the UK and many countries of the world, not least because medical costs are rising. However, prompt treatment that is free at the point of need and provided without questions being asked has a lot going for it.

There wasn't much evidence of 'spiritual care' whilst I was there. No mention of hospital chaplains for example. However, there is obviously some form of Sunday worship service because a volunteer came around the ward on Sunday lunch time to ask if anyone wanted to go (I was in the process of being discharged by then).

And on my first afternoon on the ward I watched a local methodist minister visit someone who is part of her congregation. Sadly she left before I could say 'hi' but it opened up an interesting conversation between the two of us later in the day.